JAYANTHI VENKATARAMAN - Academia.edu (original) (raw)

Papers by JAYANTHI VENKATARAMAN

Research paper thumbnail of Mortality from Crohn's disease in Leicestershire, 1972-1989: an epidemiological community based study

Research paper thumbnail of Explant liver evaluation decodes the mystery of cryptogenic cirrhosis!

Research paper thumbnail of Isolated Terminal Ileal Mucosal Changes: When is the Bite Indicated?

Journal of Digestive Endoscopy

Aim: This study aims to determine the clinical presentation, and ileal mucosal changes during col... more Aim: This study aims to determine the clinical presentation, and ileal mucosal changes during colonoscopy for which terminal ileal (TI) biopsies were taken at our center and to determine the specific histopathology which had the best yield for specific colonoscopy findings. Materials and Methods: Retrospective audit of all patients who underwent colonoscopy with ileoscopy between 2012 and 2016. All patients with TI mucosal changes and normal colonic mucosa, who underwent ileal biopsy, were included in this study. Patient data regarding age, gender, indication for ileocolonoscopy (screening for colorectal cancers, inflammatory bowel disease [IBD], or irritable bowel syndrome [IBS]) and histopathology changes were collected. Appropriate statistical tests were used and P < 0.05 was considered statistically significant. Results: One hundred and nine patients had isolated ileal lesions. The median age was 44.1 years (range 8–80 years). Men outnumbered women in a ratio of 82:27. The ma...

Research paper thumbnail of Incidence and risk factors for mortality in patients with cirrhosis awaiting liver transplantation

Indian Journal of Transplantation

Aim: This study aimed to determine the mortality in Indian patients awaiting liver transplantatio... more Aim: This study aimed to determine the mortality in Indian patients awaiting liver transplantation and to assess the impact of cirrhosis-related complications (CRCs) on mortality. Materials and Methods: This was a prospective study on patients of Indian origin, aged >18 years, with cirrhosis liver (confirmed by imaging and/or liver biopsy), and registered for liver transplant (LTx) between November 2015 and May 2016. Patients were followed up for at least a year. Any admission or day-care procedure for complications after registration was recorded as an event, and outcome was noted as recovered, deterioration, or death. The primary end point of the study was LTx, survival, or death. Patients undergoing transplantation were grouped with survivors for analysis of factors predicting waitlist mortality. Statistics: t-test, Chi-square test, Mann–Whitney U-test, and univariate and logistic regression analyses were used for statistical analysis. P < 0.05 was considered statistically significant. Results: A total of 227 (72.3%) registered patients survived. Waitlist mortality at 1 year was 27.7%, and the waitlist mortality rate was 33.8 deaths/100 patient-years. A significant proportion of nonsurvivors belonged to the Child–Turcotte–Pugh C score (P = 0.031), with higher Model for End Stage Liver Disease (P = 0.002) and greater frequency of CRC (P < 0.001). Hepatic encephalopathy (HE), renal dysfunction (RD), infection, and variceal bleeding were significantly associated with death. A higher proportion of nonsurvivors had combination of more than two CRCs. Conclusion: The waitlist mortality was 27.7%. Complications such as variceal bleed, spontaneous bacterial peritonitis, HE, and RD were significantly high in nonsurvivors.

Research paper thumbnail of Chicago classification for minor peristaltic abnormalities—Much ado about nothing!

Indian Journal of Gastroenterology

Sir In the past two decades, esophageal manometry has evolved from “visually unattractive and dif... more Sir In the past two decades, esophageal manometry has evolved from “visually unattractive and difficult to interpret” conventional manometry to more “colorful and interesting” high-resolution esophageal manometry (HREM) [1]. To establish uniformity in reporting, Chicago classification (CC), initially 2.0 [2] and later 3.0 [3], were proposed by the experts. The details of changes incorporated in CC 3.0 are highlighted in Table 1. These changes have resulted in newer nomenclature of peristaltic findings but with no significant consequence to patient care. The present study was done to determine the change in HREM diagnosis in patients who underwent HREM using CC 2.0 and CC 3.0, and its relevance to clinical practice. The study was conducted at the GI Motility Unit, Gleneagles Global Health City, Chennai. Analysis of data was retrospective. Manometry protocol:Medications that are likely to affect the smooth muscle contraction or lower esophageal sphincter relaxation, such as prokinetics and anti-cholinergics, were withdrawn for 14 days prior to the recording. Informed consent was obtained. HREM recording was done using 5 mL water for 10 swallows in supine posture, using 16 channel water perfusion system (J Hebbard, Australia) and reporting was done using Trace 1.3.3 software (J Hebbard, Australia). All HREM records of patients were re-analyzed using CC 2.0 and 3.0. The manometry diagnosis was categorized as follows:

Research paper thumbnail of Health-related quality of life in liver cirrhosis patients using SF-36 and CLDQ questionnaires

Clinical and Experimental Hepatology

Research paper thumbnail of Cannulation in patients with large periampullary diverticulum using SpyBite miniforceps

Clinical and experimental hepatology, 2018

Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success... more Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success rate varies from 61% to 95.4%. Four cases with PAD in which, despite repeated attempts, we were unable to locate the papilla and cannulate. To overcome this difficulty, we used SpyBite forceps (Boston Scientific) to pull out the papillary orifice and then perform the cannulation using a sphincterotome introduced through the same working channel. This method reduced the time required for cannulation. In all four of our cases, we had 100% success in cannulation. Use of SpyBite miniforceps in difficult cannulations in patients with PAD is useful and has an excellent success rate.

Research paper thumbnail of Gastric cancer in India: epidemiology and standard of treatment

Updates in surgery, 2018

India has a low incidence of gastric cancer. It ranks among the top five most common cancers. Reg... more India has a low incidence of gastric cancer. It ranks among the top five most common cancers. Regional diversity of incidence is of importance. It is the second most common cause of cancer related deaths among Indian men and women in the age between 15 and 44. Helicobacter pylori carcinogenesis is low in India. Advanced stage at presentation is a cause of concern. Basic and clinical research in India reveals a globally comparable standard of care and outcome. The large population, sociodemographic profile and challenges in health expenditure, however, remain a major challenge for health care policy managers. The newer formation of National Cancer Grid, integration of national databases and the creation of social identification database Aadhaar by The Unique Identification Authority of India are set to enhance the health care provision and optimal outcome.

Research paper thumbnail of Vitamin D levels in ulcerative colitis at first diagnosis: Does it "bell the cat"?

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, May 1, 2018

Research paper thumbnail of SX-Ella Danis stent in massive upper gastrointestinal bleeding in cirrhosis - a case series

Clinical and experimental hepatology, 2018

We report our experience of three cases of decompensated cirrhosis with massive upper gastrointes... more We report our experience of three cases of decompensated cirrhosis with massive upper gastrointestinal bleeding, which required insertion of an SX-Ella Danis stent for hemostasis. The procedure is safe and effective.

Research paper thumbnail of A rare cause of gastrointestinal bleeding in the post-transplant setting

Clinical and experimental hepatology, 2017

Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication noted afte... more Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication noted after solid organ transplantation and is frequently related to Epstein-Barr virus infection. The present case highlights an unusual presentation of PTLD - gastrointestinal bleeding - in the absence of systemic symptoms.

Research paper thumbnail of Gastroesophageal Reflux—Is It Uncommon in Indian Patients With Decompensated Liver Cirrhosis?

Journal of Clinical and Experimental Hepatology

Research paper thumbnail of Cellulitis in liver cirrhosis - a series of 25 cases from southern India

Clinical and experimental hepatology, 2018

Cirrhosis of the liver predisposes patients to serious bacterial infections including cellulitis.... more Cirrhosis of the liver predisposes patients to serious bacterial infections including cellulitis. The aim of the study was to determine the clinical and bacteriological profile of cellulitis in patients with liver cirrhosis. In this prospective study, consecutive cirrhotic patients hospitalized between February and September 2017 were enrolled. Data retrieved included demographics, aetiology, co-morbidity, cirrhosis-related complications, site of cellulitis, baseline investigations, and wound and blood culture. Three hundred and thirty-eight patients were admitted, of whom 25 had cellulitis (mean age 52.8 ± 10.4 years, men 88.0%, median MELD [model of end-stage liver disease] 18.8 ± 10.4). Non-alcoholic steatohepatitis and alcohol were each the cause of cirrhosis in 40% of cases. Nine patients (36%) had diabetes mellitus. Cultures were positive in 13 cases (52%; 1 - blood, 11 - wound, 1 - both blood and skin). The majority of the cultures showed monomicrobial growth (9; 70%). was th...

Research paper thumbnail of Clinical predictors and gender-wise variations in dyssynergic defecation disorders

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, May 1, 2018

There is insufficient data from India regarding clinical predictors of dyssynergic defecation. To... more There is insufficient data from India regarding clinical predictors of dyssynergic defecation. To identify demography, symptom, and colonoscopic parameters that can predict dyssynergic defecation (DD) among patients with chronic constipation (CC) and to compare the profile among male and female patients with DD. Data collected from three centers during June 2014 to May 2017 included age, gender, symptom duration, form and consistency of stools, digital examination, colonoscopy, and anorectal manometry (ARM). Patients were grouped based on ARM diagnosis: group I (normal study) and group II (DD). The two groups were compared for demography, symptom profile, and colonoscopy findings. Gender-wise subset analysis was done for those with the normal and abnormal ARM using chi-square and unpaired t tests. Of 236 patients with CC evaluated, 130 (55%) had normal ARM and 106 (45%) had DD. Male sex, straining during defecation, bleeding per rectum, and abnormal colonoscopic diagnosis were signi...

Research paper thumbnail of An Insight into Antibiotic Resistance to Bacterial Infection in Chronic Liver Disease

Journal of Clinical and Experimental Hepatology

Research paper thumbnail of Medical image. Progressive dysphagia in a 32-year-old woman--what is your call?

The New Zealand Medical Journal, Feb 11, 2011

Research paper thumbnail of Iconography : Upper gastrointestinal bleed in a woman with systemic sclerosis

Data Revues 22107401 V35i2 S2210740110004407, Mar 17, 2011

Research paper thumbnail of Medical image. Recurrent muscle cramps in chronic diarrhoea. Primary intestinal lymphangiectasia

The New Zealand Medical Journal, 2009

Research paper thumbnail of Langerhans cell histiocytosis and choledocholithiasis: a causal relationship or coincidence?

Gastroenterology and Hepatology, Nov 1, 2012

Research paper thumbnail of Prevalence of nonalcoholic fatty liver disease and its biochemical predictors in patients with Type-2 diabetic mellitus

Experimental Clinical Hepatology, Dec 15, 2011

Research paper thumbnail of Mortality from Crohn's disease in Leicestershire, 1972-1989: an epidemiological community based study

Research paper thumbnail of Explant liver evaluation decodes the mystery of cryptogenic cirrhosis!

Research paper thumbnail of Isolated Terminal Ileal Mucosal Changes: When is the Bite Indicated?

Journal of Digestive Endoscopy

Aim: This study aims to determine the clinical presentation, and ileal mucosal changes during col... more Aim: This study aims to determine the clinical presentation, and ileal mucosal changes during colonoscopy for which terminal ileal (TI) biopsies were taken at our center and to determine the specific histopathology which had the best yield for specific colonoscopy findings. Materials and Methods: Retrospective audit of all patients who underwent colonoscopy with ileoscopy between 2012 and 2016. All patients with TI mucosal changes and normal colonic mucosa, who underwent ileal biopsy, were included in this study. Patient data regarding age, gender, indication for ileocolonoscopy (screening for colorectal cancers, inflammatory bowel disease [IBD], or irritable bowel syndrome [IBS]) and histopathology changes were collected. Appropriate statistical tests were used and P < 0.05 was considered statistically significant. Results: One hundred and nine patients had isolated ileal lesions. The median age was 44.1 years (range 8–80 years). Men outnumbered women in a ratio of 82:27. The ma...

Research paper thumbnail of Incidence and risk factors for mortality in patients with cirrhosis awaiting liver transplantation

Indian Journal of Transplantation

Aim: This study aimed to determine the mortality in Indian patients awaiting liver transplantatio... more Aim: This study aimed to determine the mortality in Indian patients awaiting liver transplantation and to assess the impact of cirrhosis-related complications (CRCs) on mortality. Materials and Methods: This was a prospective study on patients of Indian origin, aged >18 years, with cirrhosis liver (confirmed by imaging and/or liver biopsy), and registered for liver transplant (LTx) between November 2015 and May 2016. Patients were followed up for at least a year. Any admission or day-care procedure for complications after registration was recorded as an event, and outcome was noted as recovered, deterioration, or death. The primary end point of the study was LTx, survival, or death. Patients undergoing transplantation were grouped with survivors for analysis of factors predicting waitlist mortality. Statistics: t-test, Chi-square test, Mann–Whitney U-test, and univariate and logistic regression analyses were used for statistical analysis. P < 0.05 was considered statistically significant. Results: A total of 227 (72.3%) registered patients survived. Waitlist mortality at 1 year was 27.7%, and the waitlist mortality rate was 33.8 deaths/100 patient-years. A significant proportion of nonsurvivors belonged to the Child–Turcotte–Pugh C score (P = 0.031), with higher Model for End Stage Liver Disease (P = 0.002) and greater frequency of CRC (P < 0.001). Hepatic encephalopathy (HE), renal dysfunction (RD), infection, and variceal bleeding were significantly associated with death. A higher proportion of nonsurvivors had combination of more than two CRCs. Conclusion: The waitlist mortality was 27.7%. Complications such as variceal bleed, spontaneous bacterial peritonitis, HE, and RD were significantly high in nonsurvivors.

Research paper thumbnail of Chicago classification for minor peristaltic abnormalities—Much ado about nothing!

Indian Journal of Gastroenterology

Sir In the past two decades, esophageal manometry has evolved from “visually unattractive and dif... more Sir In the past two decades, esophageal manometry has evolved from “visually unattractive and difficult to interpret” conventional manometry to more “colorful and interesting” high-resolution esophageal manometry (HREM) [1]. To establish uniformity in reporting, Chicago classification (CC), initially 2.0 [2] and later 3.0 [3], were proposed by the experts. The details of changes incorporated in CC 3.0 are highlighted in Table 1. These changes have resulted in newer nomenclature of peristaltic findings but with no significant consequence to patient care. The present study was done to determine the change in HREM diagnosis in patients who underwent HREM using CC 2.0 and CC 3.0, and its relevance to clinical practice. The study was conducted at the GI Motility Unit, Gleneagles Global Health City, Chennai. Analysis of data was retrospective. Manometry protocol:Medications that are likely to affect the smooth muscle contraction or lower esophageal sphincter relaxation, such as prokinetics and anti-cholinergics, were withdrawn for 14 days prior to the recording. Informed consent was obtained. HREM recording was done using 5 mL water for 10 swallows in supine posture, using 16 channel water perfusion system (J Hebbard, Australia) and reporting was done using Trace 1.3.3 software (J Hebbard, Australia). All HREM records of patients were re-analyzed using CC 2.0 and 3.0. The manometry diagnosis was categorized as follows:

Research paper thumbnail of Health-related quality of life in liver cirrhosis patients using SF-36 and CLDQ questionnaires

Clinical and Experimental Hepatology

Research paper thumbnail of Cannulation in patients with large periampullary diverticulum using SpyBite miniforceps

Clinical and experimental hepatology, 2018

Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success... more Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success rate varies from 61% to 95.4%. Four cases with PAD in which, despite repeated attempts, we were unable to locate the papilla and cannulate. To overcome this difficulty, we used SpyBite forceps (Boston Scientific) to pull out the papillary orifice and then perform the cannulation using a sphincterotome introduced through the same working channel. This method reduced the time required for cannulation. In all four of our cases, we had 100% success in cannulation. Use of SpyBite miniforceps in difficult cannulations in patients with PAD is useful and has an excellent success rate.

Research paper thumbnail of Gastric cancer in India: epidemiology and standard of treatment

Updates in surgery, 2018

India has a low incidence of gastric cancer. It ranks among the top five most common cancers. Reg... more India has a low incidence of gastric cancer. It ranks among the top five most common cancers. Regional diversity of incidence is of importance. It is the second most common cause of cancer related deaths among Indian men and women in the age between 15 and 44. Helicobacter pylori carcinogenesis is low in India. Advanced stage at presentation is a cause of concern. Basic and clinical research in India reveals a globally comparable standard of care and outcome. The large population, sociodemographic profile and challenges in health expenditure, however, remain a major challenge for health care policy managers. The newer formation of National Cancer Grid, integration of national databases and the creation of social identification database Aadhaar by The Unique Identification Authority of India are set to enhance the health care provision and optimal outcome.

Research paper thumbnail of Vitamin D levels in ulcerative colitis at first diagnosis: Does it "bell the cat"?

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, May 1, 2018

Research paper thumbnail of SX-Ella Danis stent in massive upper gastrointestinal bleeding in cirrhosis - a case series

Clinical and experimental hepatology, 2018

We report our experience of three cases of decompensated cirrhosis with massive upper gastrointes... more We report our experience of three cases of decompensated cirrhosis with massive upper gastrointestinal bleeding, which required insertion of an SX-Ella Danis stent for hemostasis. The procedure is safe and effective.

Research paper thumbnail of A rare cause of gastrointestinal bleeding in the post-transplant setting

Clinical and experimental hepatology, 2017

Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication noted afte... more Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication noted after solid organ transplantation and is frequently related to Epstein-Barr virus infection. The present case highlights an unusual presentation of PTLD - gastrointestinal bleeding - in the absence of systemic symptoms.

Research paper thumbnail of Gastroesophageal Reflux—Is It Uncommon in Indian Patients With Decompensated Liver Cirrhosis?

Journal of Clinical and Experimental Hepatology

Research paper thumbnail of Cellulitis in liver cirrhosis - a series of 25 cases from southern India

Clinical and experimental hepatology, 2018

Cirrhosis of the liver predisposes patients to serious bacterial infections including cellulitis.... more Cirrhosis of the liver predisposes patients to serious bacterial infections including cellulitis. The aim of the study was to determine the clinical and bacteriological profile of cellulitis in patients with liver cirrhosis. In this prospective study, consecutive cirrhotic patients hospitalized between February and September 2017 were enrolled. Data retrieved included demographics, aetiology, co-morbidity, cirrhosis-related complications, site of cellulitis, baseline investigations, and wound and blood culture. Three hundred and thirty-eight patients were admitted, of whom 25 had cellulitis (mean age 52.8 ± 10.4 years, men 88.0%, median MELD [model of end-stage liver disease] 18.8 ± 10.4). Non-alcoholic steatohepatitis and alcohol were each the cause of cirrhosis in 40% of cases. Nine patients (36%) had diabetes mellitus. Cultures were positive in 13 cases (52%; 1 - blood, 11 - wound, 1 - both blood and skin). The majority of the cultures showed monomicrobial growth (9; 70%). was th...

Research paper thumbnail of Clinical predictors and gender-wise variations in dyssynergic defecation disorders

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, May 1, 2018

There is insufficient data from India regarding clinical predictors of dyssynergic defecation. To... more There is insufficient data from India regarding clinical predictors of dyssynergic defecation. To identify demography, symptom, and colonoscopic parameters that can predict dyssynergic defecation (DD) among patients with chronic constipation (CC) and to compare the profile among male and female patients with DD. Data collected from three centers during June 2014 to May 2017 included age, gender, symptom duration, form and consistency of stools, digital examination, colonoscopy, and anorectal manometry (ARM). Patients were grouped based on ARM diagnosis: group I (normal study) and group II (DD). The two groups were compared for demography, symptom profile, and colonoscopy findings. Gender-wise subset analysis was done for those with the normal and abnormal ARM using chi-square and unpaired t tests. Of 236 patients with CC evaluated, 130 (55%) had normal ARM and 106 (45%) had DD. Male sex, straining during defecation, bleeding per rectum, and abnormal colonoscopic diagnosis were signi...

Research paper thumbnail of An Insight into Antibiotic Resistance to Bacterial Infection in Chronic Liver Disease

Journal of Clinical and Experimental Hepatology

Research paper thumbnail of Medical image. Progressive dysphagia in a 32-year-old woman--what is your call?

The New Zealand Medical Journal, Feb 11, 2011

Research paper thumbnail of Iconography : Upper gastrointestinal bleed in a woman with systemic sclerosis

Data Revues 22107401 V35i2 S2210740110004407, Mar 17, 2011

Research paper thumbnail of Medical image. Recurrent muscle cramps in chronic diarrhoea. Primary intestinal lymphangiectasia

The New Zealand Medical Journal, 2009

Research paper thumbnail of Langerhans cell histiocytosis and choledocholithiasis: a causal relationship or coincidence?

Gastroenterology and Hepatology, Nov 1, 2012

Research paper thumbnail of Prevalence of nonalcoholic fatty liver disease and its biochemical predictors in patients with Type-2 diabetic mellitus

Experimental Clinical Hepatology, Dec 15, 2011